NPI | 1942920178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TX CP025698T) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: NV 5038) |
225100000X Physical Therapist (Licence: OH PT020188) | |
225100000X Physical Therapist (Licence: SC CP022870T) | |
Enumeration Date | 2022-08-29 |
Last Update Date | 2024-02-20 |